Jordan Josiah Belden, DDS

Individual provider Active NPI General Practice Dentistry · Seal Beach, CA

NPI 1881207009 · NPPES record last updated Aug 27, 2020

Key facts

NPI
1881207009
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
105290 (CA)
Practice address
12419 Seal Beach Blvd
Seal Beach, CA 90740-2710
Phone
(562) 431-0393
NPI assigned
Aug 27, 2020
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
105290CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Bach Xuan Nguyen Dental Corporation General Practice Past
since Aug 30, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 105290 CA Yes

Addresses

Primary practice location

12419 Seal Beach Blvd
Seal Beach, CA 90740-2710

Mailing address

1431 Santa Barbara Dr
Newport Beach, CA 92660-6373
Phone (714) 390-4586

Other providers in Seal Beach, CA

All providers in Seal Beach, CA · General Practice Dentistry in California

Sources for this page

Verify at the official NPI Registry.